Although all parents face the task of toilet-training their children, very little research supports
one method of training over another. Cultural and societal attitudes seem more important than
data when it comes to deciding when a child is “ready” to be trained and choosing a training
method. One early cross-cultural study found that the median age of starting regular toilet training in London was 4.6 months, in Paris 7.8 months, and in Stockholm 12.4 months (Hindley,
Fillozat, Klackenberg, Nicolet-Meister, & Sand, 1965). In the United States, the suggested age
at which to start training has varied from 1 (!) to 24 months, with current support for 18 months
and preferably 24 months (Luxem & Christophersen, 1994). In a review of 40 years of research
on toilet training, Berk and Friman (1990) concluded that (1) most children are trained between 24 and 36 months of age, and almost all children are trained by 48 months of age;
(2) training focused on independent, voluntary control is completed later than training focused
on biological and behavioral indices of toileting readiness; and (3) the trend as of 1990 was in
the direction of later completion of training. Luxem and Christophersen (1994) indicate that
this trend toward delayed toilet training and permissiveness may have begun to reverse itself,
as the risk of acute infectious diarrhea and hepatitis has been increased by greater numbers of
children in day care who are not toilet-trained.

Whether toilet-training children earlier will increase parent–child problems related to
training is not clear. Even with the more permissive delayed approach, many parents report
problems with toilet training, including refusal, tantrums, emotional upsets (both parent and
child), avoidance through retention of urine and/or stools, strange behaviors (e.g., extreme
interest in toilets and toilet waste), and parent–child conflict (Mesibov, Schroeder, & Wesson,
1977; Schmitt, 1987). Parents' unrealistic expectations for when their children should achieve
continence may also increase parent and child stress. Shelov et al. (1981), for example, surveyed 1,435 parents and 446 physicians, and found that parents felt a child should stay dry
through the night by age 2.75 years (vs. age 5.13 years for the physicians).

The developmental and scientific literatures, although limited, do give us some general
guidelines for toilet training. Although studies and case reports demonstrate that children can
signal and withhold (for a short period) their impending bowel and bladder emptying as early
as 6 months of age (Smeets, Lancioni, Ball, & Oliva, 1985; Largo & Stutzle, 1977), this does

Print this page

While we understand printed pages are helpful to our users, this limitation is necessary
to help protect our publishers' copyrighted material and prevent its unlawful distribution.
We are sorry for any inconvenience.